Pediatric Eye Exams

Comprehensive Child Eye Exams

Pediatric Eye Exams

Vision is a critical sense that children depend on to enhance their learning in school, and in their everyday environment. The American Optometric Association recommends the following frequency for routine eye care for children.

Age (in years) Assymptomatic/Low Risk
Birth through 2 At least once
3-5 At least once
6-17 Before first grade and annually thereafter.

Why should my child have an eye exam?

A complete or comprehensive eye examination is recommended by an optometrist or ophthalmologist. Your eye care provider will evaluate the eye and vision health of your young child by assessing for the presence or absence of vision correction, eye alignment, eye health ofthe inside/outside of the eyes, and eye teaming.

Children's Eye Emergencies?

We always recommend parents or guardians to schedule a visit for their young child as soon as possible if experiencing any of the following symptoms:

  • Vision changes
  • Eye pain
  • Headaches
  • Infection around the eye
  • Muscle spasms of the eye or eyelid
  • Red eyes
  • Swelling or swollen eyes
  • Focusing eye problems
  • Excessive tearing

Screening and ruling out conditions such as:

During a comprehensive eye examination, your eye doctor will screen and rule out conditions such as:

  • Nearsightedness or Farsightedness
  • Astigmatism
  • Strabismus (eye turn)
  • Amblyopia (lazy eye)
  • Eye infections
  • Binocular vision problems (eye teaming problems)
  • Eye-focusing problems
  • Other eye conditions & diseases

Frequently Asked Questions

Are vision screenings the same as a comprehensive eye exam?
Do vision screenings rule out all eye problems or vision challenges?

A comprehensive eye examination is a thorough assessment completed by an eye doctor to ensure vision correction, eye teaming (ability for eyes to work together), and eye health. While vision screenings do have a positive impact, an eye examination by an eye doctor elicit eye problems not screened for in a vision screening or potential misses of a vision screening.

See Guideline

How much of learning is through vision in the classroom?

In 2013, the Mattel Children’s Hospital at UCLA started a study known as “Vision To Learn” model to demonstrate the importance of vision correction in the classroom.

  • UCLA doctors research showed that 80% of the classroom learning is visual
  • Students scores pre-correction (no glasses) and post-correction (with glasses) increased in math and reading (based upon GPA in those areas statistically significant)
  • Teachers and parents noticed an improvement in behavior home and in the classroom (less distracting to other kids, more focused, etc.).
  • Study was highly controlled and the screeners were highly trained professionals in a controlled setting
  • UCLA doctors reported that 80%-90% of the eye related problems were discerned

Vision to Learn
Corrective Lenses
What are symptoms or signs of vision challenges/impairment in children?

There are many signs/symptoms to watch for which may include:

  • Squinting
    • While watching TV
    • While reading a book or gaming
    • While working on a digital device
  • Moving digital devices or books too close to the face
  • Eye rubbing on one or both eyes
  • Eye turns
  • Consistent head tilts (to the right or left)
  • Misreading letters
    • Confusing “p” and “q” or “b” and “d”

We always recommend partnering with your child’s teacher to check progress in reading and writing. We also recommend reading with your child out loud to screen for any of the concerns mentioned above or other unusual symptoms/signs.

Does my child need to be able to read the letters on the chart in order to be seen?

No! Your eye doctor has been trained to complete a comprehensive eye exam objectively. This means, your eye doctor can assess eye movements, screen for eye diseases, and determine eyeglass prescriptions by trained techniques in the clinic.

Are eye exams covered by medical insurance or vision plans (using Minnesota as a point of reference)?

Many medical insurers in the state of Minnesota cover the cost of comprehensive eye exams by an eye doctor under preventative care. Many common insurers cover the cost under their pediatric benefit that may include:

  • Commercial Plans
    • Blue Cross Blue Shield of Minnesota
    • HealthPartners
    • Medica
    • UMR
    • UCare
    • TriCare
  • Medicaid Plans or MNsure Medicaid Plans
    • HealthPartners, Medica, Medicaid United Healthcare Community Plan/March Vision, UCare
  • NOTE: It is important to note this is not an exhaustive list and we always recommend checking with your insurer & plan. When scheduling, we do our best to navigate policy differences to determine each patient’s unique benefits; however, it is ultimately the responsibility of the guardian, parent, or patient.
How many preschool children and school-age children have a vision problem?

It is estimated and been studied that approximately 1 in 5 (20%) have a related problem while 1 in 4 (25%) school-age children have a vision problem. Interestingly, the Centers for Disease Control and Prevention report that less than 15% percent have had an eye care professional assess their preschool age children. This disparity shows that at least 5% of young children do not have optimal eye or vision health.

Source: Centers for Disease Control and Prevention. Vision Health Initiative.

Are vision problems and attention deficit/hyperactivity disorder (ADHD) related?
  • 15.6% of children with vision problems have a diagnosis of ADHD
  • 8.3% of children with normal vision (no problems) have a diagnosis of ADHD
  • Children with VISION PROBLEMS should be monitored for signs/symptoms of ADHD by your healthcare professional

It is known that ADHD diagnosed children are associated with vision problems more than children without an ADHD diagnosis. It is important to come up with a treatment plan to improve your child’s learning outcomes.

It is also important for your eye doctor to recognize that inattention, hyperactivity, and impulsivity could also lead to a diagnosis of ADHD by your pediatrician, psychologist, and/or psychiatrist.

See Study
See Pamphlet

Can the treatment for ADHD with stimulants affect your vision?

Stimulant medications do have vision disturbances listed as a potential side effect. However, the mechanism of why this may occur is not well understood.

In Turkey, Ankara University – Department of Ophthalmology and Department of Psychiatry enrolled all new ADHD diagnosed children into a prospective study. The study measured many different aspects of vision over time at an interval of 3 months. The following was reported:

  • Findings:
    • ADHD diagnosed individuals may have blue color vision deficiencies
    • Accommodation (eyes focusing mechanism) decreased while on stimulant medication
  • Limitations:
    • Sample size
    • Did not answer the question if stimulants affect eye focusing long-term
  • Important Note:
    • Children did not seem to notice vision related side effects even though noted over time after taking the medication.

See study

Disclaimer: We advise all patients to speak with their treating provider prior to stopping any medication.

What is eye teaming or binocular vision?

Eye teaming or binocular vision is the ability for both eyes to work together simultaneously. While 20/20 vision and eye health is important, young people can have eye conditions where the focusing system, eye teaming, or alignment is not efficient or accurate.

When is the right time to introduce contact lenses for my child?

We recommend parents speak with your eye doctor to determine the most appropriate age for your child. Depending on the child’s age, we want to ensure that your young person is responsible, understands that contact lenses require proper maintenance/care, and good hygiene always.

Contact lenses are used for many different purposes that include: slowing the progression of myopia (limiting your child’s prescription over time), improving your child’s vision at distance/near, and other modalities of wear. Check out some of the modalities of contact lenses:

How do I put eye drops in my young child or infant’s eyes?